This invention relates to an apparatus for stabilizing dental surgical templates generally, and more particularly, to an implant system for positioning and temporarily stabilizing a removable and replaceable dental surgical template at a specifically determined orientation with respect to the patient""s jawbone, and allowing for the removal and later reintroduction and repositioning of such template relative to such determined location.
When installing dental implants into a patient""s jawbone, especially when numerous teeth must be replaced or created, it is advantageous to use a dental surgical template to aid in the positioning and orientation of the dental implant drill with respect to the jawbone. The surgical template is typically comprised of a plastic, acrylic or vinyl replica of the prospective teeth to be supported by dental implants. The surgical template is then modified and readied for surgical use by manually cutting holes in the approximate and prosthetically-desirable areas where the surgeon anticipates he or she will place dental implants. These holes are made large enough to accommodate the passage of a dental implant drill, bur and/or guide pin.
Initially, indications are made on the template where the teeth are to be located. Such templates and markings used to be made by the dentist directly in the mouth based upon his own estimation. Recently computer programs have been available to assist in creating such indications.
For instance, radiopaque markers may be applied to the surgical template by applying a radiopaque material (e.g.: barium sulfate, gutta percha, silver powder-acrylic mixture, etc) to or below the surface of the replica teeth of the template to create what is generally known as a CT scan appliance. These radiopaque markers demonstrate the tooth outline and/or position of the prospective tooth or teeth to be implanted on a CT scan image. The patient wears the CT scan appliance and obtains a CT scan of the jawbone prior to having dental implant surgery. The radiopaque markers of the CT scan appliance would be readily discernible on the CT scan images and thus allow the surgeon or dentist to evaluate the available bone relative to the radiopaque tooth position markers at the proposed implant site. Currently available software, e.g. SIM/PLANT manufactured by Columbia Scientific, Inc. of Columbia, Md., reformats such CT scan data into 2- and 3-dimensional images that allow for interactive evaluation of the jawbone at proposed implant sites and surgical treatment planning by the dental implant therapist. The software further enables the dental implant therapist to perform a dental implant simulation directly on to the reformatted CT scan images. In essence, the implant surgeon can create a simulated dental implant surgical treatment plan or surgical blueprint on the patient""s CT scan images.
In U.S. Pat. No. 5,967,777, a method is described by which the three dimensional data coordinates of the above described simulated dental implant positions are transferred to a CNC milling machine that precisely mills and cuts holes into the CT scan appliance to create a surgical template. This precision computer-milled surgical template is then mated with drill guide components that precisely and accurately guide the drilling or osteotomy (i.e., drilled hole in the jawbone) creation process used at the time of dental implant surgery. It is even possible, under certain circumstances, to actually insert the dental implant through this computer-milled surgical template assembly and directly into the patient""s jawbone. When this computer-milled precision surgical template assembly is refitted to the patient""s mouth at the time of implant surgery, the surgeon""s drill is precisely guided to create implant osteotomies that accurately correspond in three dimensional position and trajectory to the simulated implant positions of the pre-surgical computerized surgical blueprint treatment plan.
When using any surgical template to assist in the drilling of dental implant osteotomies, it is generally desirable for the surgical template to be stable as well as removable and accurately repositionable in the patient""s mouth. If the surgical template is not stable, then the accuracy of the drilling process may be compromised, possibly leading to poor implant positioning and/or injury to the patient. Surgical template stability and/or fixation is required to reduce surgical drilling error and enhance proper implant positioning.
The computer-milled surgical template assembly described in U.S. Pat. No. 5,967,777 requires absolute stability during its use. This template assembly is usually supported and stabilized by the patient""s existing teeth or sometimes a combination of teeth and other prosthetically-restored teeth or implants. However, in the absence of adequate existing support required to provide necessary stabilization (e.g. in the case of complete edentulism), a method to provide such required support and stabilization is needed.
It is an object of the present invention to provide for a system and method of stabilizing, securing and/or fixing a template in the mouth that is accurately positionable at the time of the dental implant drilling/osteotomy creation process. Furthermore, if it is necessary to remove the template from the mouth at a later time, the system of the invention will allow for the reproducibly accurate and stable reintroduction of this template to the same fixed position and orientation relative to the patient""s jawbone.
The present solution is to form holes in the template and through these holes drill osteotomies that will subsequently receive a temporary stabilizing implant (TSI). Once the TSI is inserted into the jawbone of the patient, a component system is used to attach the surgical template to the TSI and thus secure, stabilize and/or fix said surgical template to the patient""s jawbone.
These holes and TSI""s would be typically spaced and positioned sufficiently around the template to support and stabilize it. Typically two to three TSI locations would be sufficient to adequately support and stabilize the template.
Once the template is stabilized, the osteotomies for the permanent dental implants can be accomplished and permanent dental implants can be installed into the bone. If the surgical template is no longer required following this implant placement, then the TSI""s can be removed. Alternatively, if it will be necessary for the surgical template to be accurately and securely reintroduced to the patient""s mouth at a later time, the TSI""s would be retained and eventually removed when the surgical template was no longer necessary.
The TSI""s may vary in function and appearance depending on the type of template required and the nature of the dental situation. The TSI""s provide a stable foundation for the accurate repositioning of the removable surgical template back into the mouth at any later time as required by the specific situation.
It should be noted that there are other existing methods, technologies under development and/or technological methods and/or devices yet to be developed that do and/or will require stabilization and/or fixation of a dental surgical template or device to the patient""s jawbone. It is the purpose of this invention to provide for the necessary stabilization and/or fixation for those entities as well.
The temporary stabilizing implant system of the present invention could also be used to temporarily stabilize and support a fixed provisional (temporary) bridge or other fixed provisional dental prosthesis.
It is an object of the present invention to provide a stabilizing implant system for accurately positioning a dental surgical template at a specifically determined orientation with respect to the patient""s jawbone.
It is a further object of the present invention to provide at least one, or a plurality of, temporary stabilizing implants that are placed into and temporarily located in a patient""s jawbone for the purpose of providing support, stabilization and/or fixation of a surgical template.
Still other objects and advantages of the invention will become clear upon review of the following detailed description in conjunction with the appended drawings.
A system of stabilizing implants are provided at specifically determined locations on a patient""s jawbone for positioning and temporarily stabilizing a dental surgical template at a fixated and stabilizing orientation with respect to the jawbone. The dental surgical template is provided with components that allow the accurate reproducible mechanical integration of said template to the system of implants. Once said surgical template is secured and fixed to the temporary stabilizing implants, the template may be used to create osteotomies in a patient""s jawbone at locations where more permanent dental implants will be installed. The temporary stabilizing implants allow for the subsequent removal and accurate repositioning and fixation of the surgical template to allow for the accurate position the surgical template during a variety of successive time periods. Once the osteotomies have been created and the dental implants installed, and/or the dental surgical template is no longer needed to plan and/or verify the location of the implant surgery, the temporary stabilizing implants may be removed from the patient""s jawbone.